Rheumatology

• Dilan Dissanayake, MD, FRCPC 
• Linda T. Hiraki, MD, ScD, FRCPC
• Andrea M. Knight, MD, MSCE
• Ronald M. Laxer, MDCM, FRCPC
• Jennifer Lee, MD, MS, FRCPC
• Deborah M. Levy, MD, MS, FRCPC, Clinical Director
• Elizaveta Limenis, MD, FRCPC
  
• Evelyn Rosenblyum, MD, FRCPC
• Earl D. Silverman, MD, FRCPC
• Lynn Spiegel, MD, FRCPC
• Shirley M.L. Tse, MD, FRCPC, Program Director
• Ruud H.J. Verstegen, MD, PhD
• Rae S.M. Yeung, MD, PhD, FRCPC 

Alisa C. Rachlis
Toronto Kindercare Pediatrics 

Phone: (416) 848-7665 
Fax: (416) 848-7664 

Clare M. Hutchinson 
North York General Hospital 
Department of Pediatrics 

Phone: (416) 756-6479 
Fax: (416) 756-6152 

Evelyn Rozenblyum 
St. Michael's Hospital  
Department of Paediatrics 

Phone: (416) 360-4000 

Gordon S. Soon 
St. Joseph's Health Centre Toronto 
Department of Paediatrics 

Phone: (416) 530-6625 

Karoon C. Danayan 
Phone: (416) 466-1311 
Fax: (416) 466-9629 

Nicholas S. Blanchette 
Mississauga Credit Valley Hospital 
Department of Paediatrics 

Phone: (905) 813-4120 
Fax: (905) 813-4128 

• Jo-Anne Marcuz, PT, M.Sc. QIPS, ACPAC (C)
• Kristi Whitney, M.Sc., B.Sc. PT, ACPAC (C)

Rheumatology Fellows

• Dr. Rana Al Sulami
• Dr. Molly Dushnicky
• Dr. Edan Itzkovitz
• Dr. Greta Mastrangelo
• Dr. Sonali Mitra
• Dr. Njood Nazer
• Dr. Rebecca Quilty
• Dr. Yulia Vyzhga

Autoinflammatory Fellows

• Dr. Alaa Shehab

Dermatomyositis Fellow

• Dr. Anwar Alkandari
• Dr. Hamada Natour

Lupus Fellows

• Dr. Oscar Mwizerwa

Vasculitis Fellows

• Dr. Hanof Alkhdher
• Dr. Gleice Clemente
• Dr. Paul Tsoukas

• Michelle Anderson, BScN, RN 
• Holly Convery, RN, BScN 
• Ma’Anne Garawan, H.B.Sc., BScN, RN 
• Diana Mariapen, RN

• Karen Chiu, PT 
• Lara Joannou, MSW, RSW 
• Neely Lerman, MSW, RSW 

Clinic Manager: Derry Tetzlaff, MScPT

Clinic Administration Team:

• Alisha Panjwani, Patient Care Information Coordinator
• Leah Moscato, Patient Care Information Coordinator
• Alexa Latourelle, Patient Care Information Coordinator

• Sinamys Bagh
• Kayla Baker
• Vanessa Carbone
• Hayyah Clairman
• Zainab Dholkawala
• Daniela Dominguez
• Olivia Garisto
• Ingrid Goh
• Hunter Hogarth
• Jida Jaffan
• Asha Jeyanathan
• Paris Moaf
• Natasha Naraidoo
• Lawrence Ng
• Kendal Thompson
• Amy Xu

Some of the SPARRK team members support the Rheumatology Clinic's daily operations. They'll greet you with fun activities to do while you wait for your health care team.

Physicians: Dr. Ronald Laxer, Dr. Dilan Dissanayake  

The Autoinflammatory Clinic at SickKids began in 2009 and provides patient consultation and follow-up, trainee teaching, and research opportunities. Autoinflammatory diseases consist of a group of disorders with activation of the early arm of the immune system. Although most of the individual disorders are rare, collectively they are relatively common resulting in a large referral load to the clinic. 

See the Autoimflammatory Syndromes Clinic Directory listing for contact details. 

Physician: Dr. Brian Feldman 

The JDM clinic was started in 1991 as one of the first comprehensive care clinics for childhood myositis in the world. Clinic protocols have been developed and a rigorous, standardized assessment process occurs at each clinic visit. An average of 60+ individual patients are followed in this clinic each year. Each patient is seen by the clinic nurse and the medical team at each visit. In addition, each patient has formal nailfold capillaroscopy measured, and a comprehensive physiotherapy assessment performed. 

Additional team members (physiotherapy practitioner and physiotherapist) are involved in the care of JDM patients. The JDM clinic provides a thorough training environment for clinical fellows, elective residents, medical students, nursing trainees, therapy trainees, etc. There are a number of ongoing local research projects in the JDM clinic; the clinic also contributes data to a number of North American and International collaborative projects. 

Please visit the JDM Clinic Directory listing for contact details.  

Physician: Dr. Shirley Tse 

In 2009, the JSpA clinic at SickKids was the first clinic for prospectively evaluating JSpA patients according to a standardized protocol with the goal of early identification and treatment in preventing the onset of permanent damage.  

Juvenile Spondyloarthritis (JSpA), also referred to as Enthesitis-Related Arthritis, is comprised of a group of HLA-B27 associated disorders characterized by joint and entheseal inflammation of the lower limbs, sacroiliac and spinal joints. Uncontrolled disease activity may lead to permanent impairments in spinal mobility and gait translating to severe functional disability akin to the adult-onset form of ankylosing spondylitis. The clinic is a joint effort with Diagnostic Imaging, Rehabilitation Sciences, Gastroenterology and Rheumatology. 

Please visit the JSpA Clinic Directory listing for contact details. 

Physician: Dr. Rae Yeung  

Kawasaki disease is a multi-system vasculitis with a predilection for the coronary arteries that is cared for through many unique paediatric specialities. KD is now the leading cause of acquired heart disease in Canadian children. At SickKids, the rheumatology division consults on every child with suspected Kawasaki disease.  

We have the largest KD program in the world outside of Asia, having cared for over 2,300 children with KD since 1999. In 2012, the multi-disciplinary KD clinic was launched to improve care for KD, and to directly address quality improvement and safety due to the alarming increase in incidence of IVIG associated hemolysis and revisits to the emergency department post hospital discharge after acute KD.  

Physician: Dr. Ronald Laxer 

The Morphea clinic is a combined subspeciality clinic serviced by Dermatology and Rheumatology at SickKids. Morphea, a rare condition with an estimated incidence of 2.7 cases per 100,000, refers to a group of skin conditions consisting of an excessive accumulation of collagen in the skin and subdermal tissues. Patients with Morphea benefit from the combined Dermatology and Rheumatology expertise in diagnosis and treatment of this rare condition.  

Please visit the Morphea Clinic Directory listing for contact details. 

Physician: Dr. Deb Levy  

The Division of Rheumatology provides care to patients in remote regions of Ontario as rheumatologists are not available locally. To improve access to care and to decrease travel for some families, a Northern Telemedicine clinic was established. Children and adolescents with arthritis require a physical examination, so traditional telemedicine with the patient at one end and physician at the other is not feasible.  

In the current clinic, an Advanced Clinician Practitioner in Arthritis Care (ACPAC)-trained physiotherapist residing in Thunder Bay is able to see and examine patients locally, with a pediatric rheumatologist (Dr. Deborah Levy) at SickKids reviewing and discussing the management plan with the family and therapist via telemedicine (through the Ontario Telemedicine Network). This clinic was initiated in 2017 with pilot research funding, and through ongoing funding from the Ontario Rheumatology Association and more recently an “Improved Models of Care” grant, long term sustainable funding is being sought. Initial evaluations and satisfaction measures of the clinic have been presented at local and national rheumatology meetings and an upcoming publication is expected. 

When possible, tests/infusion/procedures are done on an outpatient basis on 4C. Referrals are made and joint injections are scheduled in Image Guided Therapy. A rheumatology fellow and a staff physician are assigned to perform the injections. The clinic nurse co-ordinates the booking including orders, and initiates phone contact with the family to review pre-operative procedures and then sends an information letter outlining specifics discussed during the phone call.  

For quality assurance purposes, a follow-up call 48 hours post procedure is mandatory to review the patient’s status, address concerns and ensure appropriate follow-up. Medication infusions (IVIG, cyclophosphamide, infliximab, tocilizumab and rituximab) are administered on a weekly or monthly outpatient schedule according to specific patient protocols. 

We aim to coordinate formal clinic visits with 4C admissions, in order to limit the burden on families. There are some patients receiving these infusions at designated external centres that require co-ordination and monitoring by rheumatology staff. In addition, occupational and physiotherapy practitioners provide interim follow up and pre-infusion assessment for patients on 4C.  

Physician: Dr. Rayfel Schneider 

The sJIA clinic is a unique clinic worldwide which treats patients from across the province in a multidisciplinary setting. Patients with sJIA are generally quite ill and frequently require hospitalization to establish the diagnosis and initiate treatment. These children have multisystem involvement and therefore have the most severe and complex disease of all patients with JIA.  

Please visit the sJIA Clinic Directory listing for contact details. 

Physicians: Dr. Deb Levy, Dr. Earl Silverman, Dr. Linda Hiraki, Dr. Andrea Knight 

The pediatric SLE clinic at SickKids is the largest clinic of its kind in North America. Since 1984 children have been prospectively evaluated using a standardized assessment protocol. Four rheumatologists, Drs. Deborah Levy, Earl Silverman, Linda Hiraki and Andrea Knight, regularly attend the SLE clinics and are able to integrate clinical research projects into the clinical care that we provide. 

The divisions of Rheumatology, Nephrology and Adolescent Medicine come together in one location to provide a comprehensive care clinic for our children and families. This comprehensive model has become the standard for both paediatric and adult lupus clinics around North America. 

Please visit the SLE Clinic Directory listing for contact details. 

Physicians: Dr. Rae Yeung, Dr. Dilan Dissanayake  

Childhood systemic vasculitis is a heterogeneous group of diseases having blood vessel inflammation as a common feature. Affected children have multi-system involvement and often present with organ and/or life-threatening illness requiring aggressive management in the intensive care unit or complex care as hospital in-patients. To improve care for this family of diseases, decrease variation in care, enhance patient and family engagement, and advance research and training, a Multi-disciplinary Childhood Systemic Vasculitis clinic was established in June 2013.  

Please visit the Systemic Vasculitis Clinic Directory listing for contact details. 

Triage Clinic

In order to address an increase in patient consultations, a Triage Clinic was formed in 2016. The Triage Clinic allows our Allied Health Team (OT & PT) to review incoming consult requests and either direct them to a more appropriate service or provide an initial patient assessment. 

Transition Clinic

In response to the lack of proper transition resources for our arthritis patients, we have recently started an Arthritis Transition Program with a paediatric and adult rheumatologist at Women’s College Hospital.  

Physician: Dr. Deb Levy  

Inflammation of the anterior or posterior (or both) chambers of the eye can be asymptomatic and sight threatening. A combined rheumatology/ophthalmology uveitis clinic was initiated in 2017 to provide coordinated care for children and adolescents with uveitis.  

The quarterly clinic is co-led by Dr. Deborah Levy from Rheumatology and Dr. Nasrin Tehrani from Ophthalmology. Although these two divisions care for more than 200 children and adolescents with uveitis (either idiopathic, or as a manifestation of JIA or other rheumatic disease), the clinic was initiated to serve a select population of patients who would derive the greatest benefit from the combined clinic. This includes children and adolescents who have the most severe and difficult to treat uveitis, in addition to families who travel a significant distance for their appointments.  

MyChart is a secure, online patient portal that provides access to parts of your SickKids’ electronic health record such as lab and imaging tests, clinic visit summaries and messaging with your SickKids team. You can sign up to access the MyChart patient portal online.

Formed in 2017, the Rheumatology Family Advisory Council allows patients, caregivers and members of the Division of Rheumatology to come together and discuss ways to improve the way we provide care and the research we do. 

The council meets every other month for in-person/virtual meetings.

We are always looking for individuals to contribute their ideas and skills to help the council and their work groups.

Please contact the Rheumatology Family Advisory Council if you are interested in getting involved at rheumatology.fac@sickkids.ca. 

• Arthritis Society
• Autoinflammatory Alliance
• Canadian Spondylitis Association
• Cassie and Friends
• Cure JM
• Kawasaki Disease Canada
• Lupus Ontario
• Scleroderma Society of Ontario
• Systemic JIA Foundation
• Vasculitis Foundation Canada

• AboutKidsHealth
• JIA Symptom Assessor
• Teens Taking Charge

Dr. Dilan Dissanayake is a Transition Scientist, and newest addition to our faulty as well as the Research Institute. His research focus includes the UCAN CAN-DU international study and immunophenotyping of blood samples from patients with juvenile idiopathic arthritis at various stages of their disease course. Using both mass cytometry and single cell gene expression techniques, Dr. Dissanayake is using a 'multi-omic' approach to identify patterns that correlate with treatment response, with the hope of ultimately generating predictive indicators that can help guide management decisions.

Additionally, through this study, as well as through specialized disease clinics, Dr. Dissanayake is identifying patients who have an atypical or severe phenotype with a likely monogenic cause, in order to discover novel gene variants and their functional contribution to disease. By doing so, he aims to not only develop treatment options for these patients, who are often refractory to standard therapies, but also to shed light on the pathways that contribute to disease in the larger population. 

Visit Dr. Dissanayake's Google Scholar profile

Dr. Brian Feldman and his lab team work to develop, test, and/or refine study designs and outcome measures for use in clinical trials and outcome studies. Dr. Brian Feldman has made contributions to the understanding of the prognosis and treatment of juvenile dermatomyositis (JDM), the cost-effective prevention of arthropathy in severe haemophilia, the effectiveness of exercise as medicine, and other lifestyle changes in childhood chronic disease, and the course and outcome of systemic juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (SLE). 

Visit Dr. Feldman's Google Scholar profile 

Visit the Feldman Lab

Dr. Linda Hiraki is a Clinician-Scientist in the Division of Rheumatology and Scientist-Track investigator in the Genetics & Genome Biology program at SickKids. Dr. Hiraki’s current research interests include examining the genetic contribution to complex, rheumatic diseases and their associated long-term outcomes. She is applying methods that take advantage of rich, longitudinally collected clinical data along with both common and low-frequency genetic variants to discover new genetic associations with manifestations and complications of the complex disease.

Dr. Hiraki is also employing novel methods to transethnic studies of admixed populations with complex diseases. Hiraki is also interested in using repeated measures to better characterize disease course, and identify both environmental and genetic risk factors for adverse outcomes in rheumatic disease.

Visit Dr. Hiraki's PubMed profile

Visit the Hiraki Lab

Dr. Andrea Knight is a Clinician-Investigator in the Division of Rheumatology and Associate Scientist in the Neurosciences and Mental Health program at SickKids. She has investigated the burden of psychiatric morbidity as well as strategies to improve comprehensive care for youth with systemic lupus erythematosus, and other rheumatologic disease. She is also investigating the impact of inflammatory diseases such as lupus on brain structure, function and development. Dr. Knight’s clinical research program seeks to improve mental health and overall outcomes for pediatric patients with pediatric systemic lupus erythematosus (pSLE), and other rheumatologic disease.

She is utilizing cognitive and psychiatric measures along with advanced neuroimaging techniques, to examine the impact of pSLE on neurocognitive health and brain development, and to identify mechanisms of neuropsychiatric dysfunction in pSLE. Understanding the underlying mechanisms will enable development of approaches for early detection and targeted treatment of neuropsychiatric disorders in pSLE. She is using administrative data, survey and mixed methods approaches to understand the effect of psychiatric comorbidity on outcomes, and to develop and test mental health interventions for these patients. 

Visit Dr. Knight's Google Scholar Profile

Dr. Rae Yeung and her team work to understand the molecular and cellular mechanisms governing autoimmunity with a strong focus on Kawasaki disease, Systemic Vasculitis and JIA. Currently a large team has been focusing on the UCAN CAN-DU: Canada – Netherlands Personalized Medicine Network in Childhood Arthritis and Rheumatic Diseases, which received a total of $18M in funding since 2017. The network brings together clinicians, researchers, consumers and health policy makers from across Canada and the Netherlands, to share knowledge, expertise, recourses, platforms and technologies, in order to enhance the efficiency of research and ensure rapid uptake of discoveries and tools into practice and policy. 

Visit Dr. Yeung's Google Scholar profile

Visit the Yeung Lab

See more research profiles from our rheumatology staff on Google Scholar.

• Ronald Laxer 
• Deborah Levy
• Elizaveta Limenis
• Lynn Spiegel   
• Shirley Tse
• Ruud Verstegen

Cell Biology

Child Health Evaluative Sciences

Genetics & Genome Biology

Neurosciences & Mental Health

Translational Medicine

The fellowship program is a two-year clinical program and is accredited by the Royal College of Canada. The training program ensures graduates have all the required skills to function as academic paediatric rheumatologists. Our teaching faculty consists of 12 full-time and part-time rheumatologists (as well as our community rheumatology partners) with diverse clinical and research interests.  

The clinical program is one of the largest in North America and provides trainees with the opportunity to assess and manage a full spectrum of paediatric rheumatic diseases. The trainees monitor patients from admission to discharge and follow-up in the ambulatory clinics, ensuring they are able to develop an understanding of the natural history and long-term treatment of rheumatic diseases. 

The inpatient rotation includes the assessment and management of patients, as well as a consultation service which allows the trainees to see the many rheumatic manifestations of systemic disease.  

Trainees also rotate through the medical day care unit (4C) where they supervise infusions and perform intra-articular corticosteroid injections. They are also responsible for emergency room consultations.  

Trainees participate in four to six-month rotations within the general rheumatology clinic and in each of the specialized disease clinics: systemic lupus erythematosus, neonatal lupus, systemic juvenile idiopathic arthritis, juvenile spondyloarthritis, juvenile dermatomyositis, systemic vasculitis, Kawasaki disease, autoinflammatory syndromes and morphea. Trainees also participate in their own longitudinal continuity clinic during the course of their fellowship. There is exposure to community paediatric rheumatology clinics where trainees are able to learn a more community-based approach. 

Residents and fellows are required to participate in a one-month adult rheumatology rotation.  

Electives can be completed in a variety of disciplines including: paediatric immunology, orthopedics and radiology.  

The residents and fellows have a close relationship with the teaching staff who ensure there is graded responsibility with greater independence of the residents and fellows expected as they gain experience.  

There is a comprehensive academic program which has been consolidated into a weekly academic half day. This half day includes paediatric rheumatology teaching sessions (core curriculum and subspecialty rounds), research rounds (where division members and fellows present research projects or projects in evolution), journal club/clinical epidemiology rounds, pathology rounds, morbidity and mortality rounds, ethics seminars and a clinical research tools course.  

The program has a strong focus on research that trainees are expected to initiate during the first year of their training. They are expected to complete a scholarly project in either basic science, clinical, translational, educational or quality research. Projects are presented at the Department of Paediatrics' Research Day and the Rheumatic Disease Unit Research Day (Ogryzlo Day). Abstracts are usually submitted for presentation at the American College of Rheumatology Annual Meeting.  

Trainees who wish to pursue independent, investigative research careers are encouraged to complete an additional year(s) of training. 

The Division of Rheumatology offers postgraduate elective rotations of two to four weeks in duration for trainees enrolled in the University of Toronto and other residency programs. During the elective period, the resident attends Rheumatology outpatient clinics and joins the staff, fellows and medical students on the inpatient and consultation service. 

Students are integrated as a member of the Paediatric Rheumatology Program and participate in Ward Rounds, Consults and Ambulatory Clinics. They are given responsibility for history-taking, physical examination, investigation and management decisions under the supervision of the relevant medical staff. They also attend all academic sessions and rounds of the Division. 

The program offers two (2) positions under the Canadian Rheumatology Association Summer Studentship Program. This program allows for medical students to garner experience in paediatric rheumatology. They have the opportunity to see a full spectrum of paediatric rheumatic diseases. 

Applications for the 2024 summer program coming soon!

SickKids Summer Student Research (SSuRe) Program 

The SickKids Summer Student Research (SSuRe) Program offers undergraduate and medical students the opportunity to conduct research in paediatric rheumatology between May and August. Applications usually open on the SSuRe page early winter. 

Applications for the 2024 SSuRe programs now closed. Please check again in December for information on the 2025 SSuRe program.

Canadian Rheumatology Association Research Summer Studentship

The Canadian Rheumatology Association Summer Studentship Program allows Canadian medical students to gain research experience in paediatric rheumatology. Research experiences are available in both clinical or laboratory research environments.

Applications for the 2025 CRA Research Summer Studentship will be available in the winter.

The CREMS Summer Research Program provides opportunities for medical students enrolled in their first and second year at the University of Toronto to participate in pediatric rheumatology research. 

The Division of Rheumatology has a limited number of clinical research internships.

Internship placements are only available to students enrolled in a recognized clinical research program at college or university who require an internship to graduate.

Placements are not available to students enrolled in other undergraduate programs.

Applications must be sent to rheumatology.internships@sickkids.ca. 

The email subject should specify clinical research and your name. e.g., "Clinical research-John Smith"

Applications must include: 

• Resume 
• Transcript (unofficial transcripts are accepted) 
• School of study 

Thank you in advance for your application. Only successful candidates will be contacted for interviews. 

The Division of Rheumatology has a limited number of medical administrative internships.

Internship placements are only available to students enrolled in a recognized medical administrative program at college or university who require an internship to graduate.

Placements are not available to students enrolled in other undergraduate programs.

Applications must be sent to rheumatology.internships@sickkids.ca. 

The email subject should specify medical administration and your name. e.g., "Medical administration - John Smith"

Applications must include: 

• Resume 
• Transcript (unofficial transcripts are accepted) 
• School of study 

Thank you in advance for your application. Only successful candidates will be contacted for interviews.